Abstract
ABSTRACTObjectiveTo verify if there is consensus about the treatment of each type of injury or amputation of the fingertips, and if there is a statistical difference among the treatment options according to the surgeon's length of time in the hand surgery specialty.MethodsA cross-sectional survey was conducted during the 37th Brazilian Congress of Hand Surgery, when one hundred and twenty questionnaires were randomly distributed. Observing the inclusion and exclusion criteria, ninety completed questionnaires were included. The answers were submitted to descriptive and inferential analysis with a significance level of p <0.05.ResultsThis study showed agreement of 63.3% for the treatment with statistical difference for dorsal oblique injury less than 1 cm with bone exposure for the VY advancement flap alternative; 46.7% for volar tip oblique injury with bone exposure less than 1 cm for the Cross Finger alternative; 47.8% for oblique thumb volar injury greater than 1 cm with no bone exposure to the Moberg alternative; 54.4% for thumb pulp injury up to 2.5 cm with bone exposure to the Moberg alternative with proximal release, and 92.2% for antibiotic use, for the “cephalexin” alternative.ConclusionThere is no consensus regarding the treatment of most types of fingertip lesions, with agreement of 45.4%. When we subdivided by time group of specialty in hand surgery, there was an increase in agreement to 54.5% of the questions per subgroup. Further comparative studies are needed to assess the consensus among surgeons regarding the treatment of fingertip injury. Level of Evidence III; Cross-sectional survey.
Highlights
A lack of safety in the workplace, coupled with human failures related to incompetence, recklessness, alcohol use, and unpreparedness for performing high-risk activities, leads to finger amputations, with significant economic and social implications.[1]
This study showed agreement of 63.3% for the treatment with statistical difference for dorsal oblique injury less than 1 cm with bone exposure for the VY advancement flap alternative; 46.7% for volar tip oblique injury with bone exposure less than 1 cm for the Cross Finger alternative; 47.8% for oblique thumb volar injury greater than 1 cm with no bone exposure to the Moberg alternative; 54.4% for thumb pulp injury up to 2.5 cm with bone exposure to the Moberg alternative with proximal release, and 92.2% for antibiotic use, for the “cephalexin” alternative
In question 3 (Table 1, question 3) about emergency treatment for a fingertip injury of less than 1 cm without exposed bone, there was no concordance on treatment, with statistical difference, but the preferred option was secondary intention healing with 47.8%, followed by VY advancement flap with 41.1%, both with statistical difference when compared to the other alternatives
Summary
A lack of safety in the workplace, coupled with human failures related to incompetence, recklessness, alcohol use, and unpreparedness for performing high-risk activities, leads to finger amputations, with significant economic and social implications.[1] These types of injuries are more common in men between 20 and 45 years of age. Amputation of the index finger is the most. All authors declare no potential conflict of interest related to this article. Work conducted at the Department of Hand Surgery Residency, Hospital Alvorada, São Paulo, SP, Brazil. Rua José Theodoro de Lima, 1073, Morumbi.
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